Brain perfusion CT compared with15O-H2O-PET in healthy subjects

Regional cerebral blood flow [rCBF] measurements are valuable for identifying angiogenically active tumours, and perfusion computed tomography [CT] has been suggested for that purpose. This study aimed to validate rCBF measurements by perfusion CT with positron-emission tomography [PET] and15O-labelled water [15O-H2O] in healthy subjects.

RCBF was measured twice in 12 healthy subjects with15O-H2O PET and once with perfusion CT performed over the basal ganglia. Matching rCBF values in regions of interest were compared.

Measured with perfusion CT, rCBF was significantly and systematically overestimated. White matter rCBF values were 17.4 ± 2.0 (mean ± SD) mL min-1 100 g-1 for PET and 21.8 ± 3.4 mL min-1 100 g-1 for perfusion CT. Grey matter rCBF values were 48.7 ± 5.0 mL min-1 100 g-1 for PET and 71.8 ± 8.0 mL min-1 100 g-1 for perfusion CT. The overestimation of grey matter rCBF could be reduced from 47% to 20% after normalization to white matter rCBF, but the difference was still significant.

RCBF measured with perfusion CT does contain perfusion information, but neither quantitative nor relative values can substitute rCBF measured by15O-H2O PET yet. This, however, does not necessarily preclude a useful role in patient management.